Posterior circulation infarction

Case contributed by Varun Babu
Diagnosis almost certain

Presentation

Acute onset altered consciousness.

Patient Data

Age: 20 years
Gender: Male
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal
T2
This study is a stack
Sagittal
T1
This study is a stack
Coronal
This study is a stack
Sagittal T1
C+ fat sat
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Info

Symmetric areas of T1 hypointensity, T2 and T2 FLAIR hyperintensity with diffusion restriction is seen involving bilateral caudal midbrain and cranial pons and left cerebellar hemisphere suggestive of acute non haemorrhagic infarctions. Post contrast study revealed non opacification of the basilar tip.

Case Discussion

Acute onset loss of consciousness in a young man was referred to us with the suspicion of a viral encephalitis in the monsoons in this part of the world. What we found instead was a large brain stem infarction due to occlusion of the basilar tip. 

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